Neither the government nor the private sector has established an effective rehabilitation program for seniors, and the costs to keep them in prison are rising fast. Expenses associated with elder care helped push annual medical costs at correctional facilities past 6 billion yen (more than $50 million) in 2015, an 80 percent increase from a decade before. Specialized workers have been hired to help older inmates with bathing and toileting during the day, but at night these tasks are handled by guards.